Antipsychotic drugs; vendor drug program; Oklahoma Health Care Authority; prior authorized; disorders; prior authorization; effective date.

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ENGROSSED HOUSE
BILL NO. 2801 By: Marti of the House

and

Stanley of the Senate

[ antipsychotic drugs - vendor drug program –
disorders - prior authorization - effective date ]

BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
SECTION 1. AMENDATORY 56 O.S. 2021, Section 204, is
amended to read as follows:
Section 204. A. Except as otherwise provided, the Oklahoma
Health Care Authority shall be authorized and directed to establish
a vendor drug program to provide any drugs that have been approved
and designated as safe and effective by the federal Food and Drug
Administration, and that are prescribed by a licensed medical,
dental, podiatric, or osteopathic practitioner for eligible
recipients of assistance payments suffering from painful or life-
endangering diseases or other persons who are suffering from a
catastrophic illness.
B. The Authority shall, in accordance with federal law, not be
obligated to cover any outpatient drugs of a manufacturer which has

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not entered into or which does not have in effect a rebate agreement
with the Secretary of Health and Human Services on behalf of the
state.
C. Such program shall, to the fullest extent possible, be
established and maintained in conjunction with existing federal
programs of prescribed drugs so as to earn the maximum of federal
financial participation. Exempt from the provisions of this section
are the following drugs or classes of drugs, or their medical uses:
1. Agents when used for anorexia or weight gain;
2. Agents when used to promote fertility;
3. Agents when used for cosmetic purposes or hair growth;
4. Agents when used for the symptomatic relief of coughs and
colds;
5. Agents when used to promote smoking cessation;
6. Prescription vitamins and mineral products, except prenatal
vitamins and fluoride preparations;
7. Nonprescription drugs;
8. Covered outpatient drugs when the manufacturer seeks to
require as a condition of sale that associated tests or monitoring
services be purchased exclusively from the manufacturer or its
designee;
9. Drugs described in paragraph 3 of subsection c of Section
107 of the Drug Amendments of 1962, 21 U.S.C., Section 107(c)(3),
and identical, similar or related drugs, within the meaning of

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paragraph 1 of subsection b of Section 310.6 of Title 21 of the Code
of Federal Regulations;
10. Barbiturates; or
11. Benzodiazepines;
provided, however, the Authority shall be authorized to include
specific drugs within these categories for reimbursement based upon
specific medical need.
D. The Authority shall be authorized to establish a prospective
drug utilization review program for the H2 Antagonists; provided
that such limitations are in compliance with federal Food and Drug
Administration Agency-approved product labeling.
E. The Authority shall approve a prior authorization request
for any Food and Drug Administration approved atypical antipsychotic
that is not on the preferred drug list for the treatment and
prevention of mood disorders with psychotic symptoms including
bipolar disorders, schizophrenia, and schizotypal or delusion
disorders. Medications included under this section shall be
available at parity to other branded medications in the same class.
Approval shall be based on patient's claims history or health care
provider attestation of one of the following conditions for the
Medicaid client:
1. A trial and failure of any preferred atypical antipsychotic
in the preceding three hundred sixty-five (365) days; or

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2. The patient is stable on an atypical antipsychotic that is
not included on the preferred drug list.
SECTION 2. This act shall become effective November 1, 2025.
Passed the House of Representatives the 10th day of March, 2025.

Presiding Officer of the House
of Representatives

Passed the Senate the ___ day of __________, 2025.

Presiding Officer of the Senate